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Individual

MRS. CAROL DARLENE RICHMOND-STEPHENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
226 WHITEOAK AVE, RALEIGH, MS 39153-6082
(601) 782-9919
(601) 825-8130
Mailing address
PO BOX 24116, JACKSON, MS 39225-4116
(601) 825-7280
(601) 825-7280

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
R887063
MS
363LF0000X
Family Nurse Practitioner
F1008041
AL

Other

Enumeration date
01/20/2009
Last updated
01/13/2012
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